WILLEMSTAD, Curacao -- Last week, the new minister of public health, Sigfried Victorina, noted two cases of the zika virus present in Curacao and, given the proximity to Venezuela, Suriname and Brazil, the island may find its borders more than a little compromised. In addition, it is now reported that the virus, which is typically transmitted by the Aedes species mosquitoes, also has a sexual transmission mode.

History

According to the Centers for Disease Control and Prevention (CDC), the zika virus (ZIKV) is a mosquito-borne arbovirus in the family Flaviviridae, genus Flavivirus and it was first isolated in 1947 from a rhesus monkey in the Zika forest of Uganda, Africa, and sporadic human cases were reported from the 1960s in Asia and Africa.

However, the first reported large outbreak occurred in 2007 on Yap Island, Micronesia. The largest known ZIKV outbreak reported started in October 2013 in French Polynesia, South Pacific, a territory of France comprising 67 inhabited islands; where an estimated 28,000 persons (11% of the population) sought medical care for the illness.

The most common symptoms of zika fever are rash, fever, arthralgia (pain in the joints), and conjunctivitis (inflammation of the conjunctiva part of the eye). Most of the patients had mild disease, but severe neurologic complications have been described in other patients in French Polynesia.

A patient who was infected with ZIKV in southeastern Senegal in 2008, after returning to his home in Colorado, United States, he experienced common symptoms of ZIKV infection and symptoms of prostatitis (inflammation of the prostate gland). Four days later, he observed signs of hematospermia (blood in semen) and, on the same day, his wife had symptoms of ZIKV infection; therefore, since the wife of the patient had not traveled outside of the United States during the previous year and had sexual intercourse with him one day after he returned home, transmission by semen was suggested but not investigated. ZIKV infection of the patient and his wife was confirmed by serologic testing.

Furthermore, in December 2013, during a zika virus (ZIKV) outbreak in French Polynesia, a patient in Tahiti sought treatment for hematospermia, and ZIKV was isolated from his semen. ZIKV transmission by sexual intercourse has been previously suspected. This observation supports the possibility that ZIKV could be transmitted sexually.

Implications

Safer sex practice or abstinence may avoid transmission in addition to safe practices involving avoiding mosquito bites. For males, any signs of blood in the semen should be alerted immediately to a healthcare service provider.

CDC graphicAlert to the Dutch Caribbean

As noted, with the proximity to Venezuela, Suriname and Brazil less than 1 megameter and a high migratory phase from South America, Curacao may find its borders more than a little compromised.

The two cases already present in Curacao, with a population of approximately 0.154 million (2013), is equivalent to 1.3% of the population, compared to 12 cases in Netherlands with a population of 16.8 million (2013) equivalent to 0.00007%, which is approximately 19x103 more in danger from the zika virus.

However, in the face of an ongoing problem of little education on sexual health as demonstrated by the large cases of HIV positive in Curacao, if this virus has a sexual transmission mode then those numbers could increase and a number of person could already have been infected and be harbouring the virus in their semen, blood or even like the deadly Ebola virus (which belongs to a different family called the filovirus) the zika virus could be likely dormant and present in the eye.

If a health crisis erupts in Curacao, this could place a strain on an already strained Curacao public healthcare system and an ever increasing national debt, especially when coupled with the fact of microcephalic children, encephalitis, or unexplained neurological cases.

Recently, the Dutch minister of public health, Edith Schippers, called on Curacao, Aruba and St Maarten to do more to prevent the spread of the virus, but Prime Minister Whitman, a doctor educated in medicine in Colombia, said it was too early to issue a travel advisory for pregnant women.

Latin American-Caribbean Basin Socio-Economic Impact

The four competing candidate cities for the 2016 Olympics included Chicago, USA; Madrid, Spain; Tokyo, Japan; and Rio de Janeiro. Brazil. However, the IOC did not promote Doha to the candidature phase, despite scoring higher than selected candidate city Rio de Janeiro. Doha is an the Islamic capital city of Qatar, located in southwest Asia with a sole land border of Saudi Arabia to the south and the the Persian Gulf, which separates Qatar from Bahrain, United Arab Emirates and Iran.

On the other hand from an economic perspective, China is the largest Brazilian partner in terms of import and export, despite any ill faith of the awarded Brazilian city the virus was first noted in Africa and Asia. This may sound like an economic diet for Brazil in 2016 and more onlookers and fewer stadium filled events.

Other possible postulations have linked the fact that the increasing numbers of Cuban doctors and medical professional presence throughout Brazil via the Cuban Medical Mission in cooperation with the Brazilian federal government program "Mais Medicos" could be a possible source of the Brazilian outbreak for the zika virus.

Of over 14,000 doctors commissioned in the "Mais Medicos" program, 80% are Cubans, according to the Brazilian health ministry, which also stated that the program is designed to invest in hospital infrastructure and bring doctors to low population areas facing a shortage of health professionals. This number of Cuban doctors does not include physicians’ assistants, nurses, and other health care providers and Cubans in other sectors of public health care attention and services commissioned for work in Brazil.

According to reports, the communist government in Cuba fought a tremendous battle against dengue fever from the early 2000s and a surprisingly high number of Cuban medical mission participants in Venezuela, Bolivia and Brazil were tested and found to be infected with chikungunya. During the same time a massive amount of Cubans were commissioned to go to Africa.

The US Department of Health and Human Services (HHS), World Health Organisation (WHO), Pan American Health Organisation (PAHO) and CDC are continuously attempting to further understand the epidemic and the virus that is spread by the hungry female Aedes species, which feeds by day when children and students are at school and adults are at work.

CDC graphicPossible Bioterrorism Implications

There are also some conspiracy theorists that believe that this may merely be a pilot testing ground on a nanomolecular level global warfare of international terrorism.

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